Since stagnation of Qi is a Full pattern, constipation is therefore simply due to Heat, Cold,
Fullness, or Emptiness.

Diagnosis

When diagnosing the causes and type of constipation, it is important to take into account the
following factors:

• Stools shape


• Moisture of stools


• Pain


• Effort of defaecation


• Colour.

Stools Shape

Stools which are round and small like pebbles indicate Heat if they are very dry or Liver-Qi
stagnation if they are not dry.

Long and thin stools like pencils indicate Spleen-Qi deficiency. It should be kept in mind that
they may indicate carcinoma of the bowel. Figure 19.1(410) shows normal stools, stools in
Liver-Qi stagnation, and in Spleen deficiency.

Moisture of Stools

Dry stools indicate Heat or deficiency of Yin. Apart from other symptoms and signs, thirst and
dryness of the mouth are an important differentiating symptom. With Heat, there is intense thirst
with desire to drink large amounts of cold water. With Yin deficiency there is only a dryness of
the mouth with desire to sip water.

Loose stools which are hesitant and difficult to come out indicate Spleen-Qi deficiency with
stagnation of Liver-Qi.

Watery, explosive stools splashing in all directions indicates either Damp-Heat (in which case
the stools are yellow and frothy) or Damp-Cold.

Pain

Constipation with abdominal pain points to stagnation of Liver-Qi or Cold. Pain from stagnation